3 Altitude Restrictions

16 ALTITUDE RESTRICTIONS PURPOSE: To establish guidelines for altitude considerations in the helicopter and fixed wing aircraft based on patient diagnosis. PROCEDURE: The flight crew will notify the pilot of suggested altitudes based on the patient’s signs and symptoms or medical diagnosis. When possible, the patient will not be taken above the maximum cabin altitude as listed below. The ability to comply with these recommendations may be impacted by 1) need for IFR clearance during transport, or 2) directives given by AirTraffic Control: I. 2000 feet and below A. Acute congestive heart failure B. Acute myocardial infarction (within 8 weeks) C. Cor Pulmonale with accompanying cyanosis & respiratory acidosis D. Extensive 2nd and 3rd degree burns II. 4000 feet and below A. Cardiac disease with cyanosis or decompensation B. Active GI bleed D. Intra-Cranial Hemorrhage (ICH) III. 5000 feet and below A. Gas enclosed in a body cavity without decompression 1. Intestinal obstruction 2. Abdominal perforation 3. Recent abdominal surgery (less than 10 days) 4. Untreated pneumothorax or known emphysematous blebs 5. Penetrating head injury or pneumo-encephalogram in previous 12-hours IV. 6000 feet or below A. Recent acute myocardial infarction (within 8-24 weeks) B. Active Angina Pectoris C. Sickle cell disease D. PO2 less than 80 mmHg V. 8000 feet or below A. Respiratory disease with vital capacity < 900ml B. Cardiac valve defect C. Space occupying lesion D. Anemia: RBC < 3,000,000/mmg HGB < 8.5 % HCT < 25% E. Thoracic or abdominal surgery within 10 days 17 F. Active seizures with a history of epilepsy VI. 10,000 feet or below A. Suspected cardio-respiratory disease

Reviewed/Revised: 10/98, 4/2001, 01/04, 03/05, 03/07, 02/09